Racial gap still wide for use of statins, painkillers

As the US inches closer to 2050—when the Census Bureau estimates minority groups will become the new majority—two recent studies suggest that the treatment paradigm among blacks, whites and Hispanics remains uneven, despite measures to level the playing field.

According to research published in the American Heart Journal, even as prescription drug coverage under Medicare Part D expanded to cover more blacks, they still remain less likely to receive statins, and more of them have trouble keeping their cholesterol under control than whites.

The researchers measured lipid levels of black and white adults over 70 years of age who suffered from either coronary heart disease or diabetes.

Pre-Part D expansion, researchers found that fewer black than white adults were taking cholesterol medication, to the tune of 33% vs. 49%. Post Part-D saw a 16% hike in blacks taking statins; however, the gap between the two persisted with only 48% on statins versus 65% of whites.

That treatment gap translates into double the amount of African Americans having “poor lipid control,” according to researchers: 24% of black adults vs. only 13% of whites studied. They suggested that out-of-pocket costs are, in part, to blame for the disparate use of medication among those at risk.

For Steven Millerman, CEO of multicultural healthcare agency Prime Access, and previously head of cross-cultural marketing at Novartis, this disparity reflects the level of commitment from industry. “It almost seems too obvious,” he told MM&M. “It's such an obvious point that why wouldn't you invest in this area. But it ultimately comes down to the business case for [multicultural marketing].

“The challenge is not how to communicate with this audience,” he added, “The ultimate challenge is the industry side itself. It's people actually getting out there and doing it. Brand companies feel like they're already covering this space with their existing promotion.”

And so far, according to a study from less than two years ago from Global Advertising Strategies, the industry appears to be falling short, despite some efforts, in an audience that's growing into a more meaningful stakeholder every year. The research found that branded pharma websites are often devoid of African-American imagery, and bilingual sections of websites can be lacking.

According to Millerman, the industry has been stuck in neutral since that survey was conducted. “I believe overall it's stayed the same," he said. "Some companies are doing more than others, but the net effect has been that we're in the same place.”

Another recent analysis—published in Pediatrics—also found that it's not just adults who are being left out, and that the diverging treatment landscape isn't relegated to statins alone. The study, “Association of Race and Ethnicity with Management of Abdominal Pain in the Emergency Department," found that black children who go to an ER with stomach pain are less likely to receive pain medication and tend to wait longer in the ER than white children.

Black children were 68% percent more likely to wait longer than six hours in the ER. Researchers also found that 27% of white children received painkillers for stomach pain, while only 18.9% of Hispanics, 15.8% of blacks, and 7.1% of children from other races reported receiving analgesics for their pain.

The study's lead author, Dr. Tiffani J. Johnson of the University of Pennsylvania School of Medicine, told The New York Times that the reasons for this disparity aren't clear. “It could be that white parents are more likely to ask for pain meds, or that minority patients are likely to get care in ERs that have longer wait times. And it could be racial bias.”

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